Juniper's questions

[Crimson Nape]

juniper - I have merged your 4 threads into one. This was done because they all dealt with your therapy. Please use this thread for all posts that relate to your therapy. This will allow the reader a better frame of reference in order to help you.
- Red

[juniper]

OK. Thanks.

[stevew168]

Since you have mostly central apneas, I would not suggest setting the minimum pressure to 11. You might benefit with setting EPR to 1 vs. 3. Setting the ramp to auto is probably best, if you like it. I sometimes did that when I had an apap. Reducing your minimum pressure to 6 and ramp pressure to 5 might also help reduce your central apneas, if that is comfortable. Also changing response to standard might help the apap respond faster to both central and obstructive apneas, if you still find that comfortable.

[juniper]

I tried lowering my EPR to twice but found it very uncomfortable and got up and raised is back to 3. Why would lowering it help with centrals?

Why would a lower minimum help with centrals?

[stevew168]

I tried lowering my EPR to twice but found it very uncomfortable and got up and raised is back to 3. Why would lowering it help with centrals?

Why would a lower minimum help with centrals?

You might have noticed that your cpap lowers the pressure when you are having centrals. That is because higher pressure tends to cause more centrals because it purges more CO2. An increase of CO2 signals to your brain to cause you to breathe. Lowering EPR tends to reduce tidal volume, which can cause less purging of CO2, but if that is uncomfortable for you, leave it the same. Changing response to standard also allows your apap to lower the pressure faster when you are having centrals, which should reduce them.

[juniper]

Actually, I don't notice anything. I have no idea how to read the OSCAR charts.  You see this on my charts somewhere?


APAP mean automatic, right? As in, airsense autoset? I've been watching the Lanky guy. He seems to think that is a bad thing and we should be setting a constant pressure. He shows all these fancy charts and explains why, but I don't get it.  Anyway, that's why I crept my minimum pressure setting up from 4 to 10, because it always seemed to land there (according to the screen on the machine, I don't understand OSCAR). I was tying to use a constant pressure. That did help with OSA, but made CSA worse. I think. Not hugely worse, but I was below 5 until last night. 

So, when I decided to try a constant 10, the machine upped the pressure over 11. I think. I am just looking at the screen. Should I have lowered the maximum pressure?

I also started mouth taping recently. I was using a chinstrap that was uncomfortable and not working well, so I switched to tape. I also find that my cheeks puff out with the tape, and I think that wakes me up. Could that cause centrals?

And I raised my tube temp because I started getting rainout again. It's at max now, which I find a bit warm in the night. 

I'm kind of discouraged that I wake up just as often with the CPAP as I did without it, maybe from feeling warm and my cheeks puffing out. Maybe from the centrals?

There are so dang many things to keep track of. If I were just going to try to change one thing at a time to reduce centrals, what should I try first? Try the EPR again? Try the standard? Something else?

Sorry for all of the questions.

[stevew168]

Yes, APAP is automatically adjusting the pressure. I would suggest starting by changing response to standard and see how you feel with that. You could try setting to a constant pressure, but since you have both central and obstructive apneas, that might not be the best treatment. Your OSCAR graph suggests that your centrals are mostly occurring when the pressure is high, and the pressure should drop faster with the standard response setting setting when centrals occur.

You could also try lowering humidity to 4 or lower, or setting it to auto. You might be able to lower the temperature to 80 degrees F, or auto, which is the same. I use an N30i mask and have to set humidity to 1 to keep the mask itself from having rainout in the frame with temp set to 80, because that mask (and probably the N30), does not have one-way valves like the F30i. Since you are using a nasal mask, humidity does not need to be as high as with a full face mask, since you cannot mouth breathe if you are taping your mouth.

I would not be concerned with your cheeks or mouth puffing out with mouth tape as long as the tape is not leaking. That happens with me also based on video I take at night, when lying on my back. That would be something to start with, and see if it makes a difference reducing centrals and helping with comfort due to the high temperature.

[juniper]

Thanks. I just changed my auto response to standard. I also saw there had been a software update today. I saw a new thing called acoustic signal and turned it off. I think that was the microphone I've been reading about? Turning it off is OK, right? Or will that disable the snore thing? Or does it not matter?

Oddly, with no changes to any settings last night, I suddenly got better numbers. At least they look better to me. I'm still watching videos about all this, most of which are going over my head.

I'm going to try to attach recent charts.

[UnicornRider]

Chipmunk Cheeks, and Aerophagia was a problem I had for quite some time. Then I saw a thread where OpalRose described the Tongue Sucking Technique. It helped me.

https://www.apneaboard.com/forums/Thread...#pid446214

It may help.

[juniper]

Thank you, Unicorn!

Could someone tell me if I can learn the basics without information overload watching CPAP Friend? I was watching Lanky Lefty but getting overwhelmed.